The association between C-reactive protein levels and insulin therapy in obese vs nonobese veterans with type 2 diabetes mellitus.

The authors studied the association between insulin use and C-reactive protein (CRP) levels in obese (body mass index > or = 30 kg/m(2)) and nonobese (body mass index <30 kg/m(2)) patients with type 2 diabetes at the Providence Veterans Affairs Medical Center. There were 64 nonobese participants (insulin use and average daily dose, 23.4% and 7.0+/-18.2 units at baseline and 27.1% and 9.3+/-21.0 units at follow-up, respectively) and 106 obese participants (insulin use and daily dose, 39.6% and 28.2+/-47.3 units at baseline and 43.0% and 28.7+/-47.7 units at follow-up, respectively). Both use and daily dose of insulin were modeled with CRP levels of participants upon discharge from an intensive cardiac risk management clinic and at a 1-year follow-up visit using a linear mixed effects model for repeated measures. There was a significant direct association between log CRP and both insulin use and daily dose for nonobese participants (beta=0.3, P=.03 and beta=0.01, P=.02, respectively) but not for obese participants (P=.8 and P=.5, respectively). Due to the association between insulin therapy and CRP in nonobese patients, these results may aid clinicians in deciding on the initiation of insulin therapy for nonobese diabetic patients when noninsulin alternatives are available. Copyright 2010 Wiley Periodicals, Inc.